Background

Betel nut use refers to a combination of three ingredients: the nut of the betel palm (Areca catechu), part of the Piper betel vine, and lime. Anecdotal reports have indicated that small doses generally lead to euphoria and increased flow of energy while large doses often result in sedation. Although all three ingredients may contribute to these effects, most experts attribute the psychoactive effects to the alkaloids found in betel nuts.

Betel nut is reportedly used by a substantial portion of the world's population as a recreational drug due to its stimulant activity. Found originally in tropical southern Asia, betel nut has been introduced to the communities of east Africa, Madagascar, and the West Indies. There is little evidence to support the clinical use of betel nut, but the constituents have demonstrated pharmacological actions. The main active component, the alkaloid arecoline, has potent cholinergic activity.

Evidence

DISCLAIMER:
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Anemia:
Early poor- quality research reports that betel nut chewing may lessen anemia in pregnant women. Reasons for this finding are not clear, and betel nut chewing may be unsafe during pregnancy.
Grade: C

Dental cavities:
Due to the known toxicities of betel nut use and the availability of other proven products for dental hygiene, the risks of betel nut may outweigh potential benefits.
Grade: C

Saliva stimulant:
Betel nut chewing may increase salivation. However, it is not clear if this is helpful for any specific health condition. Due to known toxicities from betel nut use, the risks may outweigh any potential benefits.
Grade: C

Schizophrenia:
Preliminary poor- quality studies in humans suggest improvements in symptoms of schizophrenia with betel nut chewing. However, side effects such as tremors and stiffness have been reported. More research is necessary before a firm conclusion can be drawn.
Grade: C

Stimulant:
Betel nut use refers to a combination of three ingredients: the nut of the betel palm (Areca catechu), part of the Piper betel vine, and lime. It is believed that small doses can lead to stimulant and euphoric effects, and betel nut chewing is popular due to these effects. Chronic use of betel nuts may increase the risk of some cancers, and immediate effects can include worsening of asthma, high or low blood pressure, and abnormal heart rate. Based on the known toxicities of betel nut use, the risks may outweigh any potential benefits.
Grade: C

Stroke recovery:
Several poor- quality studies report the use of betel nut taken by mouth in patients recovering from stroke. In light of the potential toxicities of betel nut, additional evidence is needed in this area before a recommendation can be made.
Grade: C

Ulcerative colitis:
Currently, there is a lack of satisfactory evidence to recommend the use of betel nut for ulcerative colitis. Based on the known toxicities of betel nut use, the risks may outweigh any potential benefits.
Grade: C

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